Creating a Diabetic Health Summary Creating a Diabetic Health Summary Object and a Diabetic Health Object and a Diabetic Health Summary Flowsheet ObjectSummary Flowsheet Object

Lori Moore, Pharm D.Acting SFSU CAC

Acting ABQ Area CAC

Goals & Objectives

• Define an object• Review the Different Methods Used to Create Objects• Discuss the RPMS Keys and Menus Required to Create

Objects• Create Diabetic Health Summary Object• Create Diabetic Health Summary Flowsheet Objects

Objects

• What is an object?– Line of code that points to specific RPMS data– Once the code is inserted into a note the data is

retrieved from the RPMS file and automatically populates the text into the note

– Objects are surrounded by straight brackets when they are inserted into a note template

|BMI WITH CAPTION|

Objects

• Does EHR have objects available for me to use right after it is installed or do I have to create all of them?– Yes – EHR comes with standard objects ready for

use• Medication• Allergies• BMI• Demographic Information• Immunizations• Problem List• Visit Orders, CPT/POV codes, Patient Education,

Procedures, etc.

Objects

TIU Objects– Requires programming

access– Appearance is different– Allows you to pull in data

directly from the RPMS package (i.e. lab, pharmacy, etc.)

VA Health Summaries Objects– Does not require programming

access– Need to have the VAHS patch

released in the Summer 2006– Allows you to pull in data from the

health summary (i.e. women’s health data, flowsheets, etc)

TIU ObjectsS X=$$SLAB^BTIUPCC(+$G(DFN),"CREATININE-SFIH")

|LAST CREATININE-SFIH|

Last CREATININE-SFIH 7.1 H JAN 18, 2007@12:04:49

TIU ObjectsS X=$$NLAB^BTIULO7(+$G(DFN),"CREATININE-SFIH",8)

|LAST 8 CREATININE|

Last 8 CREATININE-SFIH: 7.1 H JAN 18, 2007@12:04:49 6.7 H NOV 20, 2006@09:16:24 5.8 H OCT 23, 2006@09:06:39 6.1 H SEP 11, 2006@09:21:54 6.4 H AUG 07, 2006@09:54 5.8 H JUN 08, 2006@09:25 5.3 H MAY 10, 2006@14:57:34 5.7 H MAR 31, 2006@09:05

DIABETES PATIENT CARE SUMMARY Report Date: Jun 12, 2007Patient Name: DEMO,DEMO HRN: 999990Age: 107 Sex: M Date of DM Onset: Apr 04, 2006 (Problem List)Dob: Jan 01, 1900 DM Problem #: SFH18**NOT ON DIABETES REGISTER** Primary Care Provider: Last Height: 67 inches May 30, 2007Last Weight: 156 lbs May 30, 2007 BMI: 24.4Tobacco Use:

HTN Diagnosed: YesON ACE Inhibitor/ARB in past 6 months: NoAspirin Use (in past yr): No

Last 3 BP: 120/90 May 30, 2007 120/88 May 16, 2007 120/80 Feb 08, 2006

In past 12 months:Diabetic Foot Exam: Yes May 16, 2007 (Diabetic Foot Exam, Complete)Diabetic Eye Exam: Yes May 16, 2007 (Diabetic Eye Exam)Dental Exam: No

SMBG: No Evidence in the past year

DM Education Provided (in past yr): Last Dietitian Visit:

Immunizations:Flu vaccine since August 1st: No Dec 10, 2001Pneumovax ever: Yes Dec 10, 2001 Aug 13, 2001Td in past 10 yrs: Yes Aug 13, 2001Last Documented PPD: 0 May 30, 2007Last TB Status Health Factor: EKG:

Laboratory Results (most recent):HbA1c: 5.0 Jun 12, 2007 Next most recent HbA1c: 5.5 Jun 12, 2007 Nephropathy Assessment Urine Protein: Microalbuminuria: Creatinine: 0.5 Jun 12, 2007 Estimated GFR: 109 Jun 12, 2007 Total Cholesterol: 100 Jun 12, 2007 LDL Cholesterol: HDL Cholesterol: Triglycerides: 800 Nov 01, 2005

DEMO,DEMO DOB: 1/1/1900 Chart #SFH 999990

VA HS Flowsheet

Object

VA HS Flowsheet

Object

VA HS Flowsheet Object

FLO - FlowsheetDIABETIC FLOWSHEET GLUC A1C CHOL LDL HDL PROT M-ALB CREAT TRIG ------------------------------------------------------------------------------------------ 01/12/2007 :155 : :n/r :130.2 :41 : : :0.8 :159 :203 H : : : : : : ------------------------------------------------------------------------------------------ 12/01/2006 :236 H :8.5 H : : : : : :0.7 : ------------------------------------------------------------------------------------------ 08/23/2006 :235 H :7.7 H : : : : : :0.7 : ------------------------------------------------------------------------------------------

VA Health Summary Menu/Keys

VAHS Health Summary Overall Menu ... [GMTS MANAGER]

Select EHR SETUP MENU Option: VAHS Health Summary Overall Menu: 1 Health Summary Coordinator's Menu ... 2 Health Summary Enhanced Menu ... 3 Health Summary Menu ... 4 Health Summary Maintenance Menu ...

VA Health Summary Menu/Keys

************************************* ** IHS Health Summary ** ** Health Summary Maintenance Menu ** ************************************* Version 2.0 SANTA FE HOSPITAL

IS Inquire About a Health Summary Type [APCHSINQ] HM Health Maintenance Reminders ... [APCH MENU HEALTH MAINTENANCE] PP Print Health Maintenance Item Protocols [APCHSHMIP] LS List Health Summary Types [APCHSTINQ] LC List Health Summary Components [APCHSCINQ] LM List Measurement Panel Types [APCHSMINQ] LF List Health Summary Flowsheets [APCHSFSINQ] LI List Health Summary Flowsheet Items [APCHSFIINQ] MS Create/Modify Health Summary Type [APCHSTED] MM Create/Modify Measurement Panel [APCHSMED] **> Locked with APCHSMGR MF Create/Modify Flowsheet [APCHSFSED] MI Create/Modify Flowsheet Item [APCHSFIED] **> Locked with XUPROG DS Delete Health Summary Type [APCHSTDEL] **> Locked with APCHZMGR DM Delete Measurement Panel Definition [APCHSMDEL] **> Locked with APCHZMGR DF Delete Health Summary Flowsheet [APCHSFSDEL] **> Locked with APCHZMGR DI Delete Health Summary Flowsheet Item [APCHSFIDEL] **> Locked with APCHZMGR

Creating VA HS Objects

• 1st step– VAHS Health Summary Overall Menu– Health Summary Maintenance Menu– Create/Modify Health Summary Type– Select Health Summary Type: __________– Setup Occurrence Limit &/or a Time Limit

• 2ND Step– TIU Menu for Medical Records– TIU Maintenance Menu– Document Definitions (Manager)– Create TIU/Health Summary Objects with the same name

you created in the first step

• 3rd Step– Test the object you created in EHR

Creating Flowsheet Object

• 1st Step– VAHS - Health Summary Maintenance Menu– HSH - Health Summary Menu– MF Create/Modify Flowsheet

• 2nd Step– VAHS - Health Summary Overall Menu– Health Summary Maintenance Menu (^HSM)– Create/Modify Health Summary Type– Select Health Summary Type: __________– Setup Occurrence Limit &/or a Time Limit

• 3rd Step– TIU - Menu for Medical Records– TIU - Maintenance Menu– Document Definitions (Manager)– Create TIU/Health Summary Objects with the same name you

created in the first step

• 4th Step– Test the object you created in EHR